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Andrew Edward Luckey, III

  • Male

Medical Specialty

Professional ID

  • NPI: 1568516086
  • PECOS ID: 6002845039
  • Enrollment ID: I20050809001159
  • Credential(MD, DO, DPM): MD
  • Medical School: Howard University College Of Medicine
  • Medical School Graduation Year: 1998

Hospital Service

  • Hospital CCN1: 050236
  • Business Name (LBN)1: Simi Valley Hospital Health Care Services
  • Hospital CCN2: 050549
  • Business Name (LBN)2: Los Robles Hospital Medical Center

Medical Practices

  • Organization Name: Andrew Edward Luckey Iii, M.d., Inc.
  • Group Practice ID assigned by PECOS: 2961688072
  • Number of Group Practice member: 0

Location

  • Address1: 1189 Swallow Ln
  • Address2: Suite 201
  • City: Simi Valley
  • State: California
  • Zip Code: 93065
  • Phone Number: (805)577-7977

Medicare

  • Medicare Assignment: Maybe
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):